Temporary ECMO support following lung and heart-lung transplantation

Following lung and heart-lung transplantation, pulmonary graft failure unre sponsive to aggressive conventional therapy may be fatal. Fourteen transpla nt recipients were placed on extracorporeal membrane oxygenation (ECMO) for pulmonary graft dysfunction. Nine patients had early (less than or equal t o 24 hours) graft failure while 5 had late (> 7 days) failure. Seven (78%) patients in the early group were weaned off ECMO and 5 (56%) survived to ho spital discharge. In the late group, none of the patients could be weaned o ff ECMO, yielding 100% mortality. ECMO support instituted for pulmonary gra ft failure that occurred within 24 hours of transplantation may improve pat ient survival.